Financial help for diabetes care.

Diabetes treatment is expensive. According to the American Diabetes Association, people who have this disease spend an average of $2,500 a year on drugs and medical supplies such as test strips, syringes, insulin, lancets, and insulin pumps.

Many people who have diabetes need help paying some of the bills. It's a good idea to start by looking for an insurance plan that covers as many diabetes-related expenses as possible. A variety of governmental and nongovernmental programs exist to help, depending on whether you qualify.

Medicare

Medicare is a Government program providing health care services for people who are 65 years and older. People who are disabled or have become disabled also can apply for Medicare, and limited coverage is available for people of all ages with kidney failure. To learn if you're eligible, check with your local Social Security office or call the Medicare Hotline listed below. Medicare now includes coverage for glucose monitors, test strips, and lancets. For more information about Medicare benefits, read the online brochure at http://ndep.nih.gov under "Medicare Coverage of Diabetes," or contact

Health Care Financing Administration (HCFA)

Office of Beneficiary Relations

7500 Security Boulevard, C2-26-12

Baltimore, MD 21244

Phone: 1-800-MEDICARE or

1-800-633-4227

Internet: www.medicare.gov

Medicaid

Medicaid is a State health assistance program for people based on financial need. Your income must be below a certain level to qualify for Medicaid funds. To apply, talk with a social worker or contact your local department of human services. Check the government pages of your phone book.

Health Insurance

Because health insurance is meant to cover unexpected future illnesses, diabetes that has already been diagnosed presents a problem. It is considered a "preexisting condition," so finding coverage may be difficult. Many insurance companies have a specific waiting period during which they do not cover diabetes-related expenses for new enrollees, although they will cover other medical expenses that arise during this time.

Recent State and Federal laws, however, may help. Many States now require insurance companies to cover diabetes supplies and education. The Health Insurance Portability Act, passed by Congress in 1996, limits insurance companies from denying coverage because of a preexisting condition. To find out more about these laws, contact your State insurance regulatory office. This office can also help you find an insurance company that offers individual coverage.

Managed Care

Most HMOs keep costs down by limiting the choice of doctors to those who belong to the network, restricting access to specialists, reducing hospital stays, and emphasizing preventive care. In most managed care plans, especially Medicare HMOs, you select a primary care physician who will be responsible for directing your care and referring you to specialists when he or she feels it's necessary. Some plans also cover extra benefits like prescription drugs.

For more information on managed care organizations, particularly the quality of care offered to patients, you may want to contact the National Committee for Quality Assurance (NCQA) at 1-888-275-7585 or see www.ncqa.org on the Internet.

Medicare also has many publications to help you learn more about managed care. Go to www.medicare.gov on the Internet or call 1-800-MEDICARE (1-800-633-4227) for more information.

Health Insurance After Leaving a Job

If you lose your health coverage when you leave your job, you may be able to buy "group coverage" for up to 18 months under a Federal law called the Consolidated Omnibus Budget Reconciliation Act or COBRA. Buying group coverage is cheaper than going out alone to buy individual coverage. If you have a disability, you can extend COBRA coverage for up to 29 months. COBRA may also cover young people who were insured under a parent's policy but have reached the age limit and are trying to obtain their own insurance.

The Department of Labor has published several helpful booklets on COBRA. To request these booklets, write to

Publications Desk

PWBA, Division of Public Affairs

Room N-5656

200 Constitution Avenue, NW.

Washington, DC 20210

Internet: www.dol.gov/dol/pwba/public/pubs/main.htm

If you don't qualify for coverage or if your COBRA coverage has expired, you can still seek other options:

* Some States require employers to offer conversion policies, in which you stay with your insurance company but buy individual coverage.

* Some professional or alumni organizations offer group coverage for members.

* Your State may be one of 29 with a high-risk pool for people unable to get coverage.

* Some insurance companies also offer stopgap policies designed for people who are between jobs.

Contact your State insurance regulatory office for more information on these and other options. Information on consumer health plans is also available at the U.S. Department of Labor's web site at www.dol.gov/dol/pwba/public/health.htm on the Internet.

Health Care Services

The Bureau of Primary Health Care, a service of the Health Resources and Services Administration, offers health care for people regardless of their insurance status or ability to pay. To find local health centers, call 1-800-400-2742 and ask for a directory, or visit the bureau's web site at www.bphc.hrsa.gov on the Internet.

The Department of Veterans Affairs (VA) runs hospitals and clinics that serve veterans who have service-related health problems or who simply need financial aid. If you're a veteran and would like to find out more about VA health care, call 1-800-827-1000. Many local governments have public health departments that can help people who need medical care. Your local county or city government's health and human services office can provide further information.

Hospital Care

If you're uninsured and need hospital care, you may be able to get help. In 1946, Congress passed the Hospital Survey and Construction Act, which was sponsored by Senators Lister Hill and Harold Burton and is now known as the Hill-Burton Act. Although the program originally provided hospitals with Federal grants for modernization, today it provides free or reduced-charge medical services to low-income people. The program is administered by the Department of Health and Human Services. For more information, call 1-800-638-0742 or visit www.hrsa.gov/osp/dfcr on the Internet.

Dialysis and Transplantation

Kidney failure is a complication of diabetes. In 1972, Congress passed legislation making people of any age with permanent kidney failure eligible for Medicare. To qualify for Medicare on the basis of kidney failure, you must need regular dialysis or have had a kidney transplant, and you must have worked under Social Security, the Railroad Retirement Board, or as a government employee (or be the child or spouse of someone who has), or you must already be receiving Social Security or Railroad Retirement benefits. Every American needing dialysis for chronic kidney failure is eligible for dialysis assistance. For more information, call the Health Care Financing Administration at 1-800-MEDICARE (1-800-633-4227) to request the booklet Medicare Coverage of Kidney Dialysis and Kidney Transplant Services. This booklet is also available on the Internet at www.medicare.gov under "Publications."

For information on financing an organ transplant, contact the following organization:

United Network for Organ Sharing (UNOS)

1100 Boulders Parkway, Suite 500

P.O. Box 13770

Richmond, VA 23225-8770

Phone: [phone]

Internet: www.patients.unos.org

Prescription Drugs and Medical Supplies

If you can't pay for the medicines and supplies you need without help, you should tell your health care provider. Your doctor may be able to direct you to local programs or even provide free samples.

You or your doctor can order a free filament to check feet for nerve damage. The filament (with instructions for use) is available by calling the Bureau of Primary Health Care's (BPHC's) Lower Extremity Amputation Prevention Program (LEAP) at 1-888-ASK-HRSA or 1-888-275-4772 or by accessing www.bphc.hrsa.gov/leap on the Internet.

In addition, drug companies that sell insulin or diabetes medications usually have patient assistance programs. Such programs are available only through a physician. The Directory of Prescription Drug Indigent Programs is available by contacting the following organization:

Pharmaceutical Research and

Manufacturers of America

1100 15th Street, NW.

Washington, DC 20005

Phone: [phone]

Internet: www.phrma.org/patients

An organization called the Medicine Program offers help in finding and applying for free medicines supplied by pharmaceutical companies. To request assistance, obtain an application form, available on its web site or through the mail, and list the medicines you need. Send the application back with a $5 processing fee for each medicine listed (e.g., $20 when requesting four medicines). If the Medicine Program fails to qualify you to receive the medicine, your processing fee will be returned.

The Medicine Program

PO. Box 515

Doniphan, MO 63935-0515

Phone: [phone]

Internet: www.themedicineprogram.com

Also, since programs targeted at the homeless sometimes provide aid, try contacting a local shelter for more information on how to obtain free medications and medical supplies. Check your phone book under "Human Service Organizations" or "Social Service Organizations" for the number of the nearest shelter.

Prosthetic Care

If you've had an amputation, paying for your rehabilitation expenses may be a concern. The following organizations provide financial assistance for people who need prosthetic care:

Amputee Coalition of America 

900 East Hill Avenue, Suite 285

Knoxville, TN 37915-2568

Phone: 1-888-AMP-KNOW or 1-888-267-5669

Internet: www.amputee-coalition.org

Easter Seals

230 West Monroe Street, Suite 1800

Chicago, IL 60606

Phone: [phone]

Fax: [phone]

Internet: www.easter-seals.org

Prosthetics for Diabetics Foundation

323 Reed Way

Monroe, GA 30655

Phone: [phone]

Fax: [phone]

Classroom Services

Public agencies that provide assistance to children with diabetes and other disabilities and to their families are listed on the State Resource Sheets published by the National Information Center for Children and Youth with Disabilities (NICHCY). These free resource sheets, which list the names and addresses of agencies in your State, are available by writing to

NICHCY

P.O. Box 1492

Washington, DC 20013

Internet: www.nichcy.org

College-age students who have diabetes-related disabilities may he faced not only with the costs of tuition, but also with additional expenses generally not incurred by other students. These costs may include special equipment and disability-related medical expenses not covered by insurance. Some special equipment and support services may be available at the institution, through community organizations, through the State vocational rehabilitation agency, or through specific disability organizations. The names and addresses of these and other agencies are also listed in the State Resource Sheets.

You can apply for financial aid at the financial aid office of the institution you plan to attend. A free copy of the booklet Funding Your Education is available from the U.S. Department of Education by writing to

Federal Student Aid Programs

P.O. Box 84

Washington, DC 20044-0084

Phone: [phone] or

1-800-730-8913

Internet: www.ed.gov/prog_info/SFA/FYE

The HEATH Resource Center (National Clearinghouse on Postsecondary Education for Individuals with Disabilities) offers information on sources of financial aid and the education of students with a disability. Write to

HEATH Resource Center

American Council on Education 

One Dupont Circle, NW.

Washington, DC 20036

Internet: www.acenet.edu/about/programs/access&equity/HEATH/home.html

Information on grants that are available to individuals for financing higher education is available at the following nonprofit organization's library:

The Foundation Center

79 Fifth Avenue

New York, NY 10003

Phone: [phone]

Fax: [phone]

Internet: www.fdncenter.org

Technological Assistance

Assistive technology, which can help people with disabilities function more effectively at home, at work, and in the community, can include computers, adaptive equipment, wheelchairs, bathroom modifications, and medical or corrective services. The following organizations provide information, awareness, and training in the use of technology to aid people with disabilities:

Alliance for Technology Access (ATA)

2175 East Francisco Boulevard, Suite L

San Rafael, CA 94901

Phone: [phone] or [phone]

Email: [e-mail]

Internet: www.ataccess.org

Assistive Technology Funding and Systems

Change Project

United Cerebral Palsy 

1660 L Street, NW., Suite 700

Washington, DC 20036

Phone: [phone], ext. 7144, or [phone]

Fax: [phone]

Email: [e-mail]

Internet: www.ucpa.org/text/innovative/atfsc/index.html

Food and Nutrition 

Food, nutrition education, and access to health care services are also available through the U.S. Department of Agriculture's WIC (Women, Infants, and Children) program. Pregnant women who meet residential, financial need, and nutrition risk criteria are eligible for assistance. Gestational diabetes is considered a medically based nutrition risk and would qualify a woman for assistance through the WIC program if she meets the financial need requirements and has lived in a particular State the required amount of time. The WIC web site provides a page of contact information for each State and Indian tribe, or you can contact the national headquarters at the following address:

USDA Food and Nutrition Service 

Public Information Staff

3101 Park Center Drive, Room 819

Alexandria, VA 22302

Phone: [phone]

Internet: www.fns.usda.gov/wic

Local Resources

Finally, for help in financing some of the many expenses related to diabetes, you may also want to seek out available local resources, such as the following charitable groups:

* Lions Clubs International, which can help with vision care.

* Rotary Clubs, which provide humanitarian and educational assistance.

* Elks Clubs, which provide charitable activities that benefit youth and veterans.

* Shriners, which offer need-based treatment for children at Shriners hospitals throughout the country.

* Kiwanis Clubs, which conduct fundraising events and projects to help the community and especially children.

* Religious organizations.

In many areas, nonprofit or special interest groups such as those listed above can sometimes provide financial assistance or help with fund-raising. In addition, some local governments may have special trusts set up to help people in need. You can find out more about such groups at your local library or your local city or county government's health and human services office.

National Diabetes Information Clearinghouse 

1 Information Way

Bethesda, MD 20892-3560

Phone: [phone] or [phone]

Fax: [phone]

Email: [e-mail]

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1978, the clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This information was accurate as of August 2000. Contact each organization directly for the most up-to-date information.